Al Sommer gives a child vitamin A drops

The Other Al Sommer

By Brian W. Simpson

One story is told more often than any other about Al Sommer. As the public health community well knows, he discovered that one micronutrient could reduce child deaths by 34 percent. And his dogged advocacy of that discovery turned data into international action that still saves hundreds of thousands of lives every year. The vitamin A story is an enduring testament to the power of public health, but it is only one part of the legacy of Sommer, who stepped down as the Bloomberg School dean on September 1. In ophthalmology, infectious disease research, disaster relief, global leadership, the Bloomberg School's history and other areas, he has made remarkable, lasting contributions.

Meet Alfred Sommer, public health's renaissance man.

Disaster Relief

Two weeks after a cyclone and flooding claimed more than 200,000 lives in East Pakistan (now Bangladesh) in November 1970, Alfred Sommer was on a U.S. Army helicopter, dropping into villages to assess the devastation and reporting back on the survivors' needs. A freshly trained officer of the Epidemic Intelligence Service, Sommer had been sent to the region to work on cholera research, but his priorities changed after word spread of the coastal disaster. Initial local responses and international efforts to the flooding had been bungled. "There was a gigantic waste of resources and effort," recalls W. Henry Mosley, MD, MPH '65, then director of the epidemiology division of the Cholera Research Laboratory in Dhaka. Mosley sent Sommer and three other teams to the region. The survey they carried out, and a second, larger one led by Sommer two months later, not only redirected relief efforts but also established the importance of using epidemiological methods in disaster situations. He and Mosley wrote up their findings in a pioneering journal article—Sommer's first. It was published in The Lancet.

"Dhaka changed him forever." —W. Henry Mosley, who as head of the epidemiology division of the Cholera Research Laboratory in Dhaka, hired Alfred Sommer in 1970



One year after the cyclone disaster, Sommer was fighting a new crisis: smallpox. After East Pakistan became the independent nation of Bangladesh in December 1971, refugees who had fled to India to avoid the revolutionary violence began streaming home—bringing the highly infectious virus with them. In April 1972, smallpox broke out in the city of Khulna. Within a few months, it infected more than 1,300 people and killed almost 400.

Recruited by D.A. Henderson, MD, MPH '60, then leader of the World Health Organization's program to eradicate smallpox, Sommer organized teams to vaccinate people in the city and a nearby refugee camp. His follow-up data on the team's control measures and their success in stopping smallpox revealed some amazing insights. Sommer showed that smallpox vaccination could still protect a person even if given days after exposure. And he demonstrated that a major epidemic could be stopped by "ring vaccination," immunizing all contacts of an infected person. After the 2001 terror attacks in the U.S., Sommer's demonstration of the effectiveness of a post-exposure vaccination—the only modern scientific data on the subject—helped persuade jittery U.S. government officials not to embark on a potentially dangerous national smallpox inoculation campaign against a possible bioterrorist attack.


Blindness Prevention

Soon after Arnall Patz, MD, became director of Hopkins' Wilmer Eye Institute in 1979, he and then School of Public Health Dean D.A. Henderson persuaded Sommer, MD, MHS '73, to lead what would become the Dana Center for Preventive Ophthalmology. Sommer hired a team of epidemiologists and statisticians who went on to conduct pioneering research in vitamin A deficiency, glaucoma, cataracts, trachoma and onchocerciasis. One example: The groundbreaking Baltimore Eye Survey, launched by Sommer in 1985, was the first community-based eye survey of adults and the prototype for dozens that have followed. The survey led to a better method for predicting glaucoma: Instead of just measuring eye pressure, doctors could diagnose the disease five years earlier and more accurately by examining changes in the nerve fibers on the retina. "It changed the paradigm," says Harry A. Quigley, MD, now director of the Dana Center and the Glaucoma Service at Wilmer.

"There are relatively few absolute, new ideas in the world. If you have one in your life, you're really something. Al Sommer has had several of them." —Bruce Spivey, Secretary General and President-Elect, International Council of Ophthalmology


Standardized Care

Well into the 1980s, American medicine, including ophthalmology, lacked recognized standards of treatment. A patient with glaucoma, for example, might get radically varied treatments from different doctors. Many in the profession thought that was just fine; they didn't want "cookbook medicine." But Bruce Spivey, then CEO of the American Academy of Ophthalmology, disagreed, and he called on Alfred Sommer to develop standards and get them accepted. "It required somebody who was intellectually rigorous but politically capable. That describes Al," says Spivey, MD. Under Sommer's leadership, guidelines were developed for treating six common conditions, including open-angle glaucoma and cataracts. The treatment guidelines, among the first of any medical specialty, are still in use today and now cover nearly two dozen eye conditions.

"Over and above being a friend and mentor, I'd call him the greatest advocate of public health in our modern day." —Keith West, DrPH '87, MPH '79, The George G. Graham Professor in Infant and Child Nutrition


Global Leadership

Every January for the past three decades, presidents, prime ministers and corporate chieftains have retreated to the Swiss mountain village of Davos for the World Economic Forum (WEF). "As our concept of the role health plays in the world—in development, in security, in sustainability—evolved, it was essential for the Forum to include the leading health experts from around the world," says WEF founder and executive chairman Klaus Schwab. In 2002, he turned to Alfred Sommer—"an obvious choice."

In addition to leading panel discussions at the Davos forum, Sommer chairs the Expert Group on Health for the WEF's Global Governance Initiative. "He has been instrumental in designing and refining our methodology and has provided a truly global spirit to the process," says Schwab, PhD.

"Al Sommer started with a large and successful school and took it to a whole new plane." —Allan Rosenfield, MD, Dean, Columbia University, Mailman School of Public Health